Histological-subtypes and anatomical location correlated in meningeal brain tumors (meningiomas)

Abstract

Context:Not enough literature is available to suggest a link between the histological subtypes of intracranial meningeal brain tumors, called ‘meningiomas’ and their location of origin.Aim:The evidence of correlation between the anatomical location of the intracranial meningiomas and the histopathological grades will facilitate specific diagnosis and accurate treatment.Materials and Methods:The retrospective study was conducted in a single high-patient-inflow Neurosurgical Center, under a standard and uniform medical protocol, over a period of 30 years from December 1982 to December 2012. The records of all the operated 729 meningiomas were analyzed from the patient files in the Medical Records Department. The biodata, x-rays, angiography, computed tomography (CT) scans, imaging, histopathological reports, and mortality were evaluated and results drawn.Results:The uncommon histopathological types of meningiomas (16.88%) had common locations of origin in the sphenoid ridge, posterior parafalcine, jugular foramen, peritorcular and intraventricular regions, cerebellopontine angle, and tentorial and petroclival areas. The histopathological World Health Organization (WHO) Grade I (Benign Type) meningiomas were noted in 89.30%, WHO Grade II (Atypical Type) in 5.90%, and WHO Grade III (Malignant Type) in 4.80% of all meningiomas. Meningiomas of 64.60% were found in females, 47.32% were in the age group of 41-50 years, and 3.43% meningiomas were found in children. An overall mortality of 6.04% was noted. WHO Grade III (malignant meningiomas) carried a high mortality (25.71%) and the most common sites of meningiomas with high mortality were: The cerebellopontine angles, intraventricular region, sphenoid ridge, tuberculum sellae, and the posterior parafalcine areas.Conclusion:The correlation between the histological subtypes and the anatomical location of intracranial meningeal brain tumors, called meningiomas, is evident, but further research is required to establish the link.

Variants of meningiomas: a review of imaging findings and clinical features

“…This histological variant corresponds to WHO grade I. Psammomatous meningiomas share common locations with typical meningiomas in the cranium [3], but in the literature, many case reports described intraspinal psammomatous meningiomas, especially in the thoracic spine [9]. CT reveals calcification diffusely or at the periphery of the tumor.…”

“…3). These three subtypes account for approximately 80 % of all meningiomas (Table 1) [3], which radiologists would identify as typical meningiomas. In contrast, each of the other histological subtypes constitutes only 1-3 % of all meningiomas, respectively.…”

Cavernous sinus syndrome: need for early diagnosis

“…A meningioma is usually hypointense to isointense with respect to grey matter in all MRI sequences, and enhances intensely and homogeneously 1 2. Meningiomas can arise primarily in the CS or grow into it as part of a larger tumour involving the medial sphenoid wing, orbit, the middle fossa, clivus or petrous bone 14 15…”

Sellar and Parasellar Imaging

“…32 With 15 subtypes in the 2007 WHO classification, they are histologically heterogeneous, although most (90%) are benign and classified as grade I. 33 Six percent of meningiomas are anaplastic (grade II) and 5% frankly malignant (grade III). 33 Meningiomas arise from arachnoid cap cells in the leptomeninges, which derive from the mesenchyme and neural crest.…”

“…33 Six percent of meningiomas are anaplastic (grade II) and 5% frankly malignant (grade III). 33 Meningiomas arise from arachnoid cap cells in the leptomeninges, which derive from the mesenchyme and neural crest. 34,35 They are almost always dural-based (but may be intraventricular or very rarely extracranial) and commonly occur along dural reflections.…”